For the study, researchers examined data on 645 women with
overactive bladder who were randomly assigned to take one of two
doses of fesoterodine (Toviaz) to treat the condition or received a
placebo, or dummy pill.
After 12 weeks, women taking medication experienced greater decrease
in so-called urge urinary incontinence than women on the placebo,
and medication was also associated with less voiding at night and
greater improvements in sleep duration, researchers report in
Obstetrics & Gynecology.
“Overactive bladder and urgency incontinence can disrupt sleep by
causing overnight urgency, incontinence, bedwetting and getting up
to urinate,” said senior study author Dr. Leslee Subak, a researcher
at Stanford University School of Medicine in California.
“If we can treat the underlying problem, a woman (or man, but we
only included women in this study) may experience less frequent
symptoms and have less disruptions of sleep,” Subak said by email.
Women are particularly prone to stress urinary incontinence, when
the pelvic floor muscles are too weak to support the bladder. As a
result, urine leaks during coughing, sneezing or exercise.
Childbirth is a common reason for weak pelvic muscles and obesity
worsens the problem.
Urge incontinence, in contrast, doesn’t have a clear cause, although
it can sometimes happen as a result of neurological problems, the
authors note.
Some women may get both types of incontinence at once or develop
bladder problems from a urinary tract infection.
In the current study, all of the women had urge incontinence and
more than half of them reported poor quality sleep, defined as a
score above 5 on a sleep-quality questionnaire. The participants
were 56 years old on average and the majority were white.
At the start of the study, women were having an average 4.6 episodes
per day of all types of urinary incontinence, and 3.9 daily episodes
of urge urinary incontinence in particular.
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After 12 weeks, women on the drug and in the placebo group
experienced fewer episodes of incontinence, but for women on the
drug the decrease was greater - they had about one less episode per
day of urge urinary incontinence than the women receiving a placebo,
the study found.
With medication, women also reported greater improvements in overall
sleep quality, sleep duration and what’s known as sleep efficiency,
or how much time people spend in bed asleep instead of awake.
One limitation of the study is that it included generally healthy
women, and results might be different for people who were elderly,
frail or suffering from a variety of chronic medical problems.
Even so, the findings offer fresh evidence of the potential for
medications for urinary incontinence to help improve sleep, said
Donald Bliwise, director of the Program in Sleep, Aging and
Chronobiology at Emory University School of Medicine in Atlanta.
“Any drug that decreases bladder activity or decreases the
production of nighttime urine might improve sleep quality,” Bliwise,
who wasn’t involved in the study, said by email.
Beyond making people tired during the day, waking frequently during
the night can lead to a variety of health problems, noted Dr. Karel
Everaert of Ghent University Hospital in Belgium. When treating
overactive bladder improves sleep, other benefits may follow.
“Sleep is extremely important to our health,” Everaert, who wasn’t
involved in the study, said by email. “Lacking it kills people
through cardiovascular disease and diabetes, and it is bothersome,
sometimes also for our partners.”
SOURCE: http://bit.ly/2EuJjXe Obstetrics & Gynecology, online
January 9, 2018.
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